Provider Demographics
NPI:1093784340
Name:AMSTERDAM, DIANE R (MD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:R
Last Name:AMSTERDAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:234 RUSSELL ST
Mailing Address - Street 2:#3
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-3534
Mailing Address - Country:US
Mailing Address - Phone:413-586-2022
Mailing Address - Fax:413-586-1679
Practice Address - Street 1:234 RUSSELL ST
Practice Address - Street 2:#3
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-3534
Practice Address - Country:US
Practice Address - Phone:413-586-2022
Practice Address - Fax:413-586-1679
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-04-05
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Provider Licenses
StateLicense IDTaxonomies
MA52989207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA052989OtherTUFTS
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA160053989OtherMEDICARE RAILROAD
MA2329163OtherUS HEALTHCARE
MA8151907003OtherCIGNA
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA2631116OtherAETNA
MA04-3194547OtherGREAT-WEST
MA8151907003OtherPRUCARE
MA131144OtherHARVARD PILGRIM
MA6178545Medicaid
MA000000020368OtherBMC
MA04-3194547OtherPLAN VISTA
MA052989OtherCONNECTICARE
MAJ03309OtherBCBSMA
MA04-3194547OtherPHCS
MA24236OtherHNE
MA6178545Medicaid
MA052989OtherCONNECTICARE